Portfolio Examination

1. Portfolio Examination Direct Restoration Competency Examiner Training Course

2. Portfolio Examination Direct Restoration competency Portfolio examiners are dental school faculty members who are chosen by their school, approved by the Board, and are trained and calibrated to conduct and grade the Board Portfolio Direct Restoration competency examination.

3. Portfolio Examination Each Portfolio examiner will undergo training and calibration in the Board’s standardized evaluation system through didactic and experiential methods.

4. Portfolio Examination Calibration of Portfolio examiners will be conducted at least annually in conjunction with the usual and customary calibration course given to the school’s competency examiners.

5. Portfolio Examination All Portfolio examiners will be trained and calibrated to use the same rating criteria.

6. Direct Restoration Competency The purpose of the Direct Restoration competency examinations are to assess the candidate’s independent ability to restore teeth with interproximal primary carious lesions to optimal form, function and esthetics.

7. Direct Restoration Competency Seven (7) scoring factors Two (2) Restorations One (1) Class II amalgam or composite; maximum one slot preparation, and One (1) Class II amalgam or composite or Class III or IV composite. Restoration can be performed on an interproximal lesion on one interproximal surface in an anterior tooth that does not connect with a second interproximal lesion which can be restored separately.

8. Direct Restoration Competency A case presentation for which the proposed treatment is appropriate for the patient’s medical and dental history, is in appropriate treatment sequence, and treatment consent is obtained. Patient Management. The examinee must be familiar with the patient’s medical and dental history.

9. Direct Restoration Competency Implementation of any treatment modifications needed that are consistent with the patient’s medical history.

10. Direct Restoration Competency The tooth used for the competency exams must meet the following criteria: A Class II must be performed on any permanent posterior tooth. Treatment must be performed in the sequence described in the treatment plan. More than one test procedure can be performed on a single tooth; teeth with multiple lesions may be restored at separate appointments.

11. Direct Restoration Competency Caries as shown on either of the two required radiographs of the unrestored proximal surface must extend to or beyond the DEJ. The tooth to be treated must be in occlusion. The restoration must have an adjacent tooth to be able to restore proximal contact; proximal surface of the dentition adjacent to the proposed restoration must be either a natural tooth or a permanent restoration. Provisional restorations or removable partial dentures are not acceptable adjacent surfaces. The tooth must be asymptomatic with no pulpal or periapical pathology. The tooth cannot be endodontically treated or need endodontic treatment. Any tooth with bonded veneer is not acceptable.

12. Direct Restoration Competency A Class III/IV must be performed on any permanent anterior tooth. Treatment must be performed in the sequence described in the treatment plan. Caries as shown on either of the two required radiographs of the unrestored proximal surface must extend to or beyond the DEJ. Carious lesions must involve the interproximal contact area.

13. Direct Restoration Competency The restoration must have an adjacent tooth to be able to restore proximal contact; proximal surface of the dentition adjacent to the proposed restoration must be either a natural tooth or a permanent restoration. Provisional restorations or removable partial dentures are not acceptable adjacent surfaces. The tooth must be asymptomatic with no pulpal or periapical pathology. The tooth cannot be endodontically treated or need endodontic treatment. The lesion is not acceptable if it is in contact with circumferential decalcification. The approach must be appropriate for the lesion. Any tooth with bonded veneer is not acceptable.

14. Direct Restoration Competency Scoring: Score of 0 is unacceptable (critical error) Score of 1 is unacceptable (multiple major deviations but correctable) Score of 2 is unacceptable (one major deviation that is correctable) Score of 3 is acceptable (minimum competence) Score of 4 is adequate (less than optimal) Score of 5 is optimal A score of “3” is minimum competency.

15. Direct Restoration Competency FACTOR 1: Case Presentation Obtains informed consent Presents a comprehensive review of medical and dental history. Provides rationale for restorative procedures. Proposes initial design of preparation and restoration. Demonstrates full understanding of the procedure.

17. Direct Restoration Competency FACTOR2: Outline and Extensions Optimal outline and extensions such as:

19. Direct Restoration Competency FACTOR 3: Internal form Optimal internal form such as:

21. Direct Restoration Competency FACTOR 4: Operative Environment Soft Tissue free of unnecessary damage Proper patient comfort/pain management Optimal isolation Correct teeth isolated Dam Fully inverted Clamp stable with no tissue damage No leakage Preparation can be accessed and visualized

23. Direct Restoration Competency FACTOR 5: Anatomical Form Optimal anatomic form such as:

25. Direct Restoration Competency FACTOR 6: Margins No deficiencies or excesses

27. Direct Restoration Competency FACTOR 7: Finish and Function Optimal finish and function such as:

29. Summary of Grading/Scoring Method